MEDICARE: DR. LISA K HASTINGS D.C,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	10031	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8F7368	OTHER	TX	PTAN

General Provider Information

NPI Number	:	1952590689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA K HASTINGS D.C,

Provider Business Mailing Address
First Line	:	2001 SOUTH 1ST ST.
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704
Country	:	US
Telephone Number	:	512-416-7700
Fax Number	:	512-697-0069

Provider Business Practice Location Address
First Line	:	2001 SOUTH 1ST ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704
Country	:	US
Telephone Number	:	512-416-7700
Fax Number	:	512-697-0069

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2007
Last Update Date	:	03/15/2013

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